Efficacy of mifepristone for cervical priming for second-trimester surgical termination of pregnancy

Objective

To determine whether mifepristone plus misoprostol was as effective as misoprostol with or without laminaria (depending on gestational age) for cervical preparation for second-trimester termination of pregnancy.

Methods

A retrospective cohort study was carried out among women who underwent surgical termination between 14 and 19 + 6 weeks of pregnancy. Those who received preoperative mifepristone were compared with those who did not. The study group received mifepristone plus misoprostol before dilation and evacuation of the uterus between May 2008 and September 2011. The comparison (non-mifepristone) group received misoprostol with or without laminaria between January 2005 and April 2008.

Results

There was no difference between the groups in terms of difficulty of cervical dilation, with an overall relative risk for moderate–difficult dilation in the mifepristone group of 0.91 (95% confidence interval, 0.49–1.68). There was no difference between the groups with regard to complications arising from the procedure.

Conclusion

Mifepristone is effective for cervical priming prior to second-trimester dilation and evacuation in both multiparous and primiparous women, without an increase in complication rates.